The (New) Big Drugs on Campus

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Going to college is an exciting time in the life of any young adult. For young people with ADHD, it’s a special challenge. They’re trading old routines for the freedom and responsibility of structuring their own time — and facing new intellectual challenges while forging new relationships. To complicate matters, these youngsters may find that the medication they’ve been taking for years has suddenly become very interesting — to their fellow students.

It’s no secret that some college students experiment with drugs. These days, the abuse isn’t limited to painkillers, tranquilizers, and street drugs like marijuana and cocaine. College students are swallowing, snorting, and even injecting stimulants typically prescribed to treat ADHD.

Kids with ADHD are unlikely to be among the abusers; evidence suggests that most view the drugs as a way to get where they need to go, not tickets to a joyride. But the popularity of ADHD drugs among those who do not have ADHD can make life very complicated for those who do.

Students who decline requests to hand over “just a few pills” may lose friends. Students who do give away (or sell) pills may skip doses — and wind up under-medicated. No matter what these youngsters do, they are subject to the innuendo that the drugs they take in order to function normally give them an unfair advantage. “They know that it helps them concentrate better,” says Mark Freeman, Ph.D., president of the American College Counselors Association. “They may wonder if they are, in fact, getting an unfair advantage.”

It doesn’t help when news reports cast doubt on the legitimacy of ADHD diagnoses. One recent TV news program, for example, featured a student who faked ADHD in order to get a prescription for Ritalin. According to the program, all he had to do was fill out a true-false questionnaire.

“The media create an aura that kids are forced to live with,” says Ashley Klein, a coach and academic advisor who works with ADHD students in Tucson, Arizona. “They have to contend with the implication that ADHD isn’t a real disorder.”

What’s the Appeal?

Some youngsters misuse ADHD medication because it gives them a high. Others do so to boost their concentration when they hit the books — to become “super students.” Truth is, ADHD drugs can amplify the ability to focus in almost everyone — not just those who have ADHD.

“Adderall is amazing,” says Doreen, an Indiana University business major who does not have ADHD. “Not only does it keep you up and help you focus, it makes you want to study. I can learn so much faster when I take it.” Finals time for Doreen has been Adderall time, since freshman year. “Almost every other business school student I know has used Adderall at one time or another,” she says.

“You see this a lot among students who have been avoiding classes and work, to get through finals and the last four weeks of school,” says Dr. Freeman. “Students are constantly told they have to excel,” says Kelly Burch-Ragan, Ph.D., president of the International Association of Addiction and Offender Counselors. “They come from high school to an environment with a lot more academic and social demands, and these drugs represent an instantaneous fix.”

Indeed, research shows that the more competitive a college’s admission standards, the higher the rate of stimulant misuse.

The Other Side of the Story

Although few kids with ADHD misuse their medication, not all are exempt from temptation. Tori, a recent college graduate, took her prescribed Ritalin when she needed to study. “But I used Adderall recreationally,” she says. “If I was really tired and I wanted to go partying, it let me stay up later, which I couldn’t do with Ritalin.”

Tori got her Adderall the same way an estimated 90 percent of those who misuse prescription stimulants do — from a fellow student. One recent survey found that more than half of college students for whom stimulant medications were prescribed had been approached to sell, trade, or give them away. Says Klein, the ADHD coach, “Usually it’s people they know — roommates, friends from study group and campus organizations. In an environment where social relationships are so important, there’s a feeling of, ‘why shouldn’t I help out my friend?'”

For young people who dislike taking medication — as well as those who are trying to convince themselves they don’t need it any more — passing their pills on to someone else is “killing two birds with one stone,” says Dr. Freeman.

Financial concerns can also be a significant factor. “Students are perennially short of money,” says Harold Meyer, head of CHADD’s New York City chapter. “I work with a number of kids who have sold their pills to buy video games or eat out.”

Risky Business

Voluntarily parting with prescribed stimulants is risky. These are controlled substances, in the same federal regulatory category as morphine and cocaine. To the judicial system, promoting their unauthorized use means trafficking in narcotics. One 19-year-old University of Oregon student found this out the hard way last April, when he was arrested and charged with a felony for selling Adderall that had been prescribed for him.

Even when law enforcement isn’t an issue, sharing pills can be dangerous. And youngsters who give away pills that they should be taking for ADHD may wind up feeling that they no longer need the medication.

“Once you start sharing, you get into the mindset that you need your medication only when studying or taking a test,” says Klein. “You start to think, ‘these pills aren’t working so well anymore.’ It’s a self-destructive cycle.” That’s particularly true, of course, when being under-medicated causes ADHD symptoms to rebound.

Media Myths

News reports often paint a distorted picture of ADHD medications, exaggerating the risk of addiction and suggesting that horrific side effects are common. ADHD medications seldom cause side effects beyond insomnia, jitteriness, or loss of appetite. But an article that appeared recently in the University of Oregon’s Daily Emerald cited two cases of “amphetamine-induced psychotic disorder.” One involved a man who shot and killed his five-year old daughter after taking Ritalin.

The same article quoted a psychiatrist who suggested that “animal studies have clearly shown that drugs like Adderall kill brain cells at routine clinical doses” and that children who are prescribed stimulants are more prone to cocaine abuse as adults. Research flatly contradicts both claims.

These distorted reports seem to be discouraging some youngsters with ADHD to take their medication as prescribed. “The publicity makes kids think more seriously about going off medication,” says Michael Sandler, a Fort Collins, Colorado, ADHD coach. “Some who haven’t tried medication decide not to.” Says Laurie Dupar, R.N., an ADHD coach who works with college students, “Because of the bad publicity, some are hesitant to go public with the fact that they have ADHD, or to receive the most appropriate treatment.”

Such reports ignore the crucial difference between taking a drug as prescribed and abusing it. “There’s nothing bad about these medications,” says Peter Jaksa, Ph.D., president and clinical director of ADD Centers of America in Chicago. “Used properly, they’re extremely safe.”

Keeping Kids on the Right Track

When it comes to ensuring that your youngster uses his ADHD medication responsibly, knowledge is power, says Dr. Jaksa. “It’s important for kids to understand why they’re taking medication, what goes on biologically, and how the drugs work.”

If your child takes a short-acting medication, consider speaking with the prescribing doctor about a different form of the medication. Short-acting drugs are easily ground up and snorted — a common and particularly dangerous way to misuse the drug. This is impossible with long-acting products like Concerta, says Andrew Adesman, M.D., chief of developmental and behavioral pediatrics at Schneider Children’s Hospital in New Hyde Park, New York. In fact, a recent study by Harvard psychiatrist Timothy E. Wilens, M.D., found that “diversion and misuse [of ADHD medications] occurred with intermediate-acting formulations and that none occurred with extended-release formulations.”

Here’s what else parents can do:

Make sure your child understands the risks. In the eyes of the law, even giving away Ritalin or Adderall represents “delivery of a controlled substance,” a felony. Consequences may range from suspension from school to forfeiture of college loans, fines, and imprisonment.

Emphasize the risk that stimulants pose when used by someone for whom they were not prescribed. “They may be safe for the majority of people, but for a kid with high blood pressure, a heart condition, or psychiatric problems, they can be quite dangerous,” says Meyer, of CHADD.

Urge your child to keep his diagnosis confidential. “I counsel my patients not to share this information with roommates or others, and advise putting medication in an unlabeled vial, in an inconspicuous place,” says Dr. Adesman. “Only my good friends know I have ADHD,” says Frank, a college senior. “They wouldn’t ask me for it.”

Encourage your child to participate in a support group. Getting together with others who have ADHD helps your child recognize that medication must be used responsibly. “Contact the college’s disability center, health center, or counseling center ahead of time, if possible,” says Klein. They can steer students to support groups.

Rehearse “refusal” scenarios, in which your child describes her disorder and explains why she is unwilling to share her medication. “Humor helps,” says Klein, who has ADHD. “If someone were to ask for my pills, I might say, ‘Okay. Can I have one of your contact lenses?'” She adds that it helps to keep a relatively small quantity of pills on hand. “That way you can claim honestly, ‘I’m almost out, and I need what I have.'”

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